HomeMy WebLinkAboutRental Application)o 2OZS Rental Registration Application
TOWN OF YARMOUTH
Health Department
I I46 ROUTE 28, SOT'TH YARMOUTH
MASSA('HT]SETTS 02664
Telephone (508) 398-2231. ext. 1240
. Fax (508) 760-3472
E-mail: mdalevra\,larnrouth.ma-us
Important Notice (PLEASE READ CAREFULLY):
If you do not receive your rental certificate within 30 days of sending in your application, please contact our
ffice immediately! Please be aware that until you receive a rental certificate from the Health Department, your
roperty is being rented-without a valid certificate, which may result in fines and other penalties.
Please note that occupancy limits are in place based on septic capacity and the number of
bedrooms. These measures are in place to protect our drinking water and aquifers. As
Yarmoutlr prepares for a future transition to a town sewer system, these steps are crucial
for preserving our water resources. Previous occupancy determinations may be subiect to
adiustment based on the criteria mentioned above,
Ia
Smoke Detectors and Carbon Monoxide Detectors are Requiredl
Ovmers: I have ensured the batteries are changed, have tested ALL Smoke Detectors/plynn
Monoxide Detectors and verified that they are less than 10 years old: P/eose initial.>S-
contad the Buildin8 Department reSard ing q uestaons on type and locaoon prior to purchasin}- "
httDs://www.ynrnoqth.ma.us/Docunren(errter/vie!!/lI22llSmoke.detector-location
. A rsrrefundable application feeof $80 per unit/rental is required.
. Rental Certificates expire on December 313t,2025.
. To register online and payvia credit card, visit the Town of Yarmouth Health Department
website: https://www.varmouth.ma.us/ 127lHealth If you prefer to pay by check, you may begin
your application online. After completing the initial steps, make your check payable to the Town of
Yarmouth, and be sure to include your BHR number (which will be provided during the online
application process) and your rental address. Make a note in the notes section that you will be
sending a check. Mail the check to the address above.
If NOT registering online, please make checks payable to: Town of Yarmouth and mail
completed application (on reverse side) & payment to: Town ofYarmouth Health Department.
See Reverse Side )
Submitting the registration application g@l! complete the process or guarantee the automatic issuance of
a rental certificate. Your application will undergo a *review process, which includes verification ofassessors'
records, septic system, the number of bedrooms and previous inspections.
*An inspection may be required as part of this process.
Please Print Clearly
Rental Property Information
Allfields are required! lncomplete fonns without a volid phone i, address, or e-moll address will notprocessed.
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Rental Property Address
eekly/short Term (less than 31 days) _
Rental Period:
ear-Round/Long Term
Trash Removal by
wner a ous e - Dupg(condo- Apartment- Room-
roperty Owner Full Name:
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7s/-/67i4'/{requrre mary one um er Alternatc Phone Num
6/2-6r/4-2S " ?r:(requircd)E-mail Address
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Representative's Primary Phone
Number:
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Representative's E-mail Address:
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Furthermore, I understand I must notib,, the Health Department in writing when I am no ronger renting theproperty, or I may be subject to fines & fees.
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Revised: 11 024
HEALTH
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